Tuesday, April 30, 2013

10 Things Vitamin Makers Won’t Say

From an article, titled "10 things vitamin makers won’t say" by Elizabeth O'Brien posted on the on-line Market Watch from the Wall Street Journal. She says "we peel back the label to see what nutrition-in-a-bottle is really worth":

1. “We overwhelm you with choices.”

There are more than 54,000 dietary supplements on the market, sold under 1,000 different brands, according to consumer groups. Indeed, the Food and Drug Administration defines a supplement broadly, as an ingestible product containing a “dietary ingredient,” which may include vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars and metabolites. And the industry is growing. Sales hit more than $30 billion in 2011, according to a report released last month by the Government Accountability Office, up from about $25 billion in 2009.

Faced with so many choices, how can consumers find a safe product? Heather Mangieri, a registered dietitian in Pittsburgh and a spokesperson for the Academy of Nutrition and Dietetics, a trade group representing food and nutrition professionals, gives her clients tips on navigating this fragmented market. Look for supplement makers that have scientific advisory boards listed on their websites, she says.

Another good sign is a gold “USP Verified” stamp on the label, showing the product has the approval of the U.S. Pharmacopeial Convention, an organization that tests supplement quality. (The absence of a USP mark doesn’t necessarily mean the product isn’t up to snuff, she notes, since some companies may choose not to pay for the verification process.)

When in doubt, call the manufacturer. It’s a red flag if you can’t reach a human being who can answer questions, experts say, and an even bigger one if there’s no contact information on the packaging.

MyAchingKnees comment: I think a USP certification, or lack thereof is telling. If a manufacturer has a superior quality product then prove it, not just claim it.

2. “Medications can’t be sold without FDA approval, but our products can.”

The FDA regulates supplements, but differently than prescription and over-the-counter drugs. Manufacturers of the latter must prove safety and efficacy before new products reach the market. By contrast, manufacturers generally do not need FDA approval before producing or selling dietary supplements, as long as the ingredients they’re using were marketed in a dietary supplement in the U.S. before the Dietary Supplement Health and Education Act of 1994 was passed. Manufacturers using “new dietary ingredients” not marketed before that law passed must notify (but not necessarily get approval from) the FDA before selling the product, and must submit materials showing the ingredient is “reasonably expected to be safe” — according to the manufacturer’s own assessment.

The FDA oversees supplements after they hit the market, and the government requires manufacturers to report all serious adverse events like a heart attack or stroke associated with the use of their supplements. Consumers can search the FDA website for warning letters it has sent to supplement makers in violation of its regulations, but there’s no searchable database for adverse event reports.

Critics say FDA regulation falls short: “Consumers are playing roulette with their health because we don’t have adequate regulation of dietary supplements,” says Chuck Bell, programs director at Consumers Union, the consumer group that publishes Consumer Reports magazine. “The state of FDA regulation is illustrative of how safe the industry is,” counters Steve Mister, president and CEO of the Council for Responsible Nutrition, a dietary supplement trade group. “We do see the FDA flex its muscle where there is a problem.” FDA spokeswoman Tamara Ward says that the FDA regulates these products according to the 1994 law, which dictates that manufacturers are responsible for marketing a safe product. While the FDA does not review most supplements for safety or effectiveness prior to marketing, she says, “if a safety issue arises, the FDA can investigate and take the necessary steps to have the product removed from the market.” Indeed, earlier this month, the FDA issued warnings about DMAA, a substance commonly used in weight-loss and muscle-building supplements, saying the agency has received 86 reports of illness and death associated with supplements containing DMAA; the FDA says it is using all tools at the agency’s disposal to ensure that supplements containing DMAA are removed from the marketplace.

3. “Good luck judging a supplement by its label.”

Federal law requires supplement ingredients to be listed on the supplements’ packaging in descending order of predominance by weight. Yet for competitive reasons, the FDA doesn’t require manufacturers to list the exact amounts of ingredients in a “proprietary blend” in the “Supplement Facts” box on the label. The words “blend” and “formula” can also be used by manufacturers to fudge the exact amounts of expensive ingredients like chondroitin, a component of cartilage that’s used in joint supplements, says Dr. Tod Cooperman, president of ConsumerLab.com, an independent supplement testing firm. His recommendation: When reading labels, focus on the ingredient you want, and make sure it’s listed alone as a discrete ingredient in the list of ingredients, not followed by the word “blend” or “formula.”

The most common quality breach that ConsumerLab.com finds when testing supplements is products that list more of an ingredient than they actually contain. For example, a supplement’s facts box might say that a pill contains 100 milligrams of a given nutrient when it really has 20, Cooperman says. The second most common breach is the reverse: supplements that list less than they actually contain of a given ingredient. This type of mislabeling happens even in mainstream products, he says. Mister, of the Council for Responsible Nutrition, says this type of mislabeling isn’t prevalent.

While labels are supposed to accurately reflect the amount of a given nutrient in a supplement, the FDA doesn’t commonly pursue these types of infractions, says Bell, of Consumers Union; it’s more common to see the FDA go after claims that a supplement helps cure or prevent diseases, he notes.

MyAchingKnees coment: It is true that the consumer cannot judge what is in food grade supplements, that is supplements manufactured under food grade standards, by their label. So let the consumer beware. ConsumerLab is a good place to start for research. I do not take anything that is not manufactured under Good Manufacturing Practices (GMP) for pharmaceuticals, nor anything does not meet United States Pharmacopeia (USP) standards and specifications for potency, uniformity, and disintegration.

4. “The health benefits are debatable.”

On packaging, the FDA allows supplement manufacturers to make so-called structure-function claims, which describe how a nutrient is intended to affect the structure or function of the human body. One example: “Curbs appetite to help with weight loss.” Manufacturers cannot, however, claim that their product cures, treats or prevents disease, as with a statement like “Aids weight loss to treat obesity.” However, in a 2012 analysis of 127 supplements by the Office of Inspector General of the Department of Health and Human Services, 20% of dietary supplements did make such claims. The FDA responded to the report by saying the agency would consider whether to seek explicit authority to review substantiation for structure-function claims beyond what the law currently allows.

While the FDA’s guidelines require that manufacturers have “competent and reliable scientific evidence” to show their claims are truthful, Dr. Margery Gass, a gynecologist and executive director of the North American Menopause Society, says most supplement claims don’t have the same science behind them that drugs do. For instance, she says, reputable studies are large scale and double-blind, meaning that neither the subjects nor the researchers know who is getting the supplement and who is getting a placebo. These types of studies are rare in the supplement industry, according to the Inspector General report. Furthermore, many supplements don’t even have human studies to support their evidence, says Bell.

Mister says this criticism misses the point: Supplements cannot be tested exactly like drugs. New drugs are “something no one has ever had in their body before,” whereas researchers can’t test the immune-boosting effects of vitamin C on a control group of individuals who have no vitamin C in their systems. “You cannot do the kinds of randomized clinical trails for vitamins that you can do for drugs,” Mister says. Even so, he notes, “Our industry doesn’t think for a minute that we can do without scientific rigor.”

MyAchingKnees comment: Of course the FDA will never allow any health benefit claims by supplements. Nutritional medicine, the idea that nutrition is your first line of defense in combatting degenerative disease, would cut into the Medical communities and Drug companies control and profit. Not all of this is done for greed. Some medical professionals sincerely believe that medications are the first and main effort.

5. “No pill is a substitute for a healthy diet.”

A sensible approach to supplements looks something like this, says Mangieri, the registered dietitian: You start with a healthy, balanced diet, then work with a doctor or dietitian to fill in any missing nutrients, if necessary, with supplements. “I’m always pushing, ‘food first,’” she says. Most people can and should get their daily dietary requirements from food alone, she says, although it can take some effort. One exception is her weight-loss clients on a diet of 1,600 calories or less — it can be tough for them to get all the nutrients they need through food, so she often recommends they take a multivitamin.

Indeed, vitamins and minerals alone can’t replicate the effects of a balanced diet, says Dr. Gary Deng, attending physician at the Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center. The best diets have “a little of this and a little of that,” and the combination of all the nutrients is more effective than those in isolation, he says, noting that studies have tried and failed to replicate the same positive impact with supplements alone.

MyAchingKnees comment: I absolutely agree that people need to eat good, whole foods and minimize the bad high glycemic foods. But who among us can do that each and every day? It is true that supplements cannot replace a balanced, low glycemic diet, but is it equally true that it is near impossible to get all your required daily nutrients from foods - hence the need to supplement.

6. “You may need a magnifying glass to read our disclaimers and warnings.”

On supplement packaging, each structure-function claim must be accompanied by a disclaimer saying that the claim hasn’t been evaluated by the FDA (and again that the product is not intended to diagnose, treat, cure or prevent any disease). Good luck finding these, though: Disclaimers are often in tiny font on the bottom of the bottle or package. Mister says that rather than a deliberate obfuscation, this usually represents manufacturers’ attempt to create an attractive, uncluttered label.

You have to look even harder to find certain other warnings. The law requires that supplements be safe for “normal conditions of use,” and many manufacturers interpret that to mean they should warn consumers if their product isn’t for everyone, Mister says. For example, many glucosamine supplements are made with the shells of shrimp, crab and lobster, so people with shellfish allergies are advised to avoid them. Yet some manufacturers aren’t so clear with their warnings, if they offer them at all, Bell says. He once found a warning on the opposite side of an iron supplement label — the side that faces the bottle — saying that the product shouldn’t be taken within two hours of oral tetracycline antibiotics, since it interferes with their absorption. “There’s a limited amount of real estate on the label,” Mister says, noting that such peel-back labels are perfectly legal.

7. “There’s no magic weight-loss pill.”

Clients at Mangieri’s dietitian practice fill out a form at their first visit that asks them what supplements they’ve taken. The list of weight loss products that she’s seen on those forms is long, she says. “People are desperate,” she says. “It’s a shame that so much money goes into products that don’t work.” Of course, not all weight-loss supplements are the same and some may be more or less helpful than others. And while weight-loss supplement makers often recommend that their product be taken as part of a larger program of diet and exercise, some in the industry doubt the necessity of taking pills. “What will cause the weight loss is the diet and exercise,” not the supplement, Mangieri says.

Mister says certain weight loss supplements, alongside diet and exercise, can make a difference. Some bulk fiber products can contribute to a feeling of satiety, he says, and cause people to eat less, while other supplements might boost a person’s metabolism a bit.

MyAchingKnees comment: Another truism, that there is no magic weight loss pill. Most diets fail because they starve the dieter of vital and necessary nutrients. A slow steady road of low glycemic foods and quality nutritional supplements, ensuring you provide your body with the required daily nutrients, is a positive and assured method to weight loss.

8. “ ‘Natural’ isn’t the same as ‘safe.’

”Arsenic, poisonous mushrooms, tobacco: Plenty of products found in nature can be dangerous. Some of the most prominent supplements to come under scrutiny in the past decade contained ephedra, an Asian herb that raises blood pressure and stresses the heart. The supplements were marketed for weight-loss and athletic performance, but after several reports of deaths and other bad health outcomes among ephedra users, the FDA found they presented an unreasonable risk of illness and injury and banned them in 2004.

Even vitamins and minerals may be harmful in excess, recent studies have suggested. Often, people think that if they take more than the recommended dose, they’ll reap even more benefits, says Dr. Gass of the North American Menopause Society. That’s not the case. A study last year out of the University of Copenhagen, for instance, found that there might be such a thing as too much vitamin D. Researchers studied blood samples from nearly 250,000 Danes and found higher mortality rates in those with low levels of vitamin D — and those with high levels of vitamin D. While the research isn’t conclusive, it does argue against overdoing it. A simple blood test can reveal a person’s vitamin D levels and show whether supplements might be needed, experts say. Research has also suggested that excess calcium can lead to an increased risk of heart disease and death.

MyAchingKnees comment: Read what I italicized above. Does that make sense to you? Higher mortality rates for people who had both low levels of Vitamin D and high levels of Vitamin D? The problem with testing single nutrients is multi-fold.....nutrients are designed to work together, synergistically, to provide your cells with all the nutrients necessary for optimal cellular health and a functioning immune system. When tests on people are conducted they cannot possible account for the varying health conditions of the participants nor can they monitor what they do 24 hours a day.

9. “Enhanced effectiveness may be due to pharmaceuticals.”

It’s illegal to try to pass off prescription drugs as dietary supplements, but that hasn’t stopped some manufacturers from trying. Some examples: Supplements to enhance male sexual performance have been found to contain sildenafil citrate, an active component of Viagra, while weight loss supplements have been found to be tainted with the prescription drug sibutramine, an ingredient found in an FDA-approved drug that was removed from the market in 2010 because it caused heart problems and stroke. In most cases, this contamination is deliberate, experts say, and the FDA has been active in trying to prevent this practice.

Mainstream manufacturers don’t spike their products with prescription drugs, Mister says. To avoid potential problems, he says, “don’t buy from an Internet company you’ve never heard of, that only has a P.O. box.”

MyAchingKnees comment: Non-essential or even harmful substances in supplements, some of which can cause positive or false positive results in banned substances testing, is what keeps Athletic associations, like the U.S. Olympic Committee, from accepting or recommending nutritional supplements except for those manufactured under GMP for pharamceuticals with guaranteed potency and purity.

10. “Your doctor needs to know what you’re taking.”

While patients often tell their doctors what prescription drugs they’re taking, they often neglect to mention the supplements. This is a mistake, experts say. Many herbal supplements interact with prescription drugs people are taking. For example, St. John’s wort, a supplement that has been shown to be effective in cases of mild depression, should not be taken alongside prescription antidepressants, says Dr. Reid Blackwelder, president-elect of the American Academy of Family Physicians and a practicing doctor in Kingsport, Tenn. Blackwelder sometimes recommends the herb to patients in lieu of drugs, along with exercise and other nonmedical therapies. Other herbal products can lessen the effectiveness of chemotherapy or radiation in cancer patients, says Barrie Cassileth, chief of the integrative medicine service at Memorial Sloan-Kettering Cancer Center in New York City: “They can create serious problems for people already very sick.”

MyAchingKnees comment: I agree, tell your Doctors, however be prepared for comments like, "Those supplements may make your prescriptions medications less effective", or, " Well, go ahead and take those supplements even thought they probably won't do any good." Really? Okay Doc, I'll just stick to what I'm doing, it's working for me.

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Saturday, April 27, 2013

South Beach Diet Doctor Warns About ‘Stealth Disease’

An article on Gluten by CNBC posted on Off the Cuff. There are an increasing amount of people who are now questioning if their diagnosis of Irritable Bowel Syndrome or other non-specific bowel disorders or pain are really an sensitivity to Gluten.

“It can really mimic almost any other disease, which is why it's often been so difficult to diagnose,” said Arthur Agatston, MD, cardiologist and the creator of the “The South Beach Diet.” He was referring to something he calls “the stealth disease” – sensitivity to gluten, a condition which he claims many of us don’t even know we have.

“We've just seen so many dramatic cases of patients who were undiagnosed for years and years,” he said. “Unfortunately, physicians are clueless when it comes to gluten. It's because a lot of the information is new.”

Gluten is the major protein found in wheat, barley and rye. Nearly ubiquitous, it’s sometimes added to lipstick, toothpaste, soy sauce, even some medicines. But if you’re sensitive to it, gluten can cause stomach pains, headaches, skin rashes, fatigue or depression, according to Agatston. It can lead to or exacerbate chronic illnesses such as rheumatoid arthritis, and fibromyalgia, he writes, in his new book “The South Beach Diet Gluten Solution.” In it, he makes a distinction between “gluten sensitivity” and celiac disease, an autoimmune disorder which affects the small intestine, and which is hereditary.

Agatston’s focus on gluten came about by accident, an outcome of how the "South Beach Diet" affected his patients. His original diet book was published in 2003, and there are more than 23 million copies of “The South Beach Diet” and its companion books in print. It was eventually published in 34 countries. “The first phase of our South Beach diet was intentionally grain-free to prevent swings in blood sugar. It was unintentionally gluten-free. I had no idea what gluten was when we wrote the book,” he said. “People lost weight. They improved their blood chemistries. We expected that. What we didn't expect was cures of psoriasis, of fibromyalgia, of several types of arthritis. And we kept seeing these really miraculous remissions of disease. I eventually realized that it was the gluten-free part, not just the grain-free, of the first phase of the diet.”

Not everyone is sensitive to gluten, Agatston said, and the first step is to find out if you are. “For most of my patients when they avoid gluten, they're avoiding all the processed carbohydrates, the fast foods. They make the diet a lifestyle because they may not be worried about not having a heart attack in 20 years, but they know if they cheat, they're going to have stomach pains and their skin's going to break out in a few days.”

“What's happened the last 20, 30 years is the way we process and prepare food is different than it used to be. We have a lot more processed food which concentrates gluten, and then we're not breaking it down. It's toxic and plays havoc with our system.” At the same time, he said “it feels like we're addicted to starch, and in many ways we are. But you can break that by going on our principles, which is the good fats, the good carbs, lean sources of protein, plenty of fiber.” He advocates “strategic snacking” in order to prevent a drop in blood sugar and to stave off cravings. His favorite snacks include almonds, mozzarella sticks, and cold cuts.

Agatston claims that gluten sensitivity, coupled with the over-prescription of antibiotics, can be particularly harmful to children. “These kids with the asthma, the ear infections, the allergies—my friends did not have them when I grew up,” he said. “A lot of them do better when you take them off gluten.”

Agatston still practices medicine. He pioneered the “Agatston Score,” a method of screening for signs of heart disease. Another predictor for increased heart risk, he said, is your body shape. Those of us who are apple-shaped, who pack weight around our stomachs, are more susceptible than our pear-shaped brethren. “If you're an apple, you really have to be worried,” he said.

How much should you control your own diet? We asked Agatston about New York Mayor Michael Bloomberg’s failed proposal to ban super-sized sugary drinks. “I tend to be a libertarian. I think there's too much government intervention,” he said, “I agree we shouldn't be having gallon sodas. I think most of our resources should go into education rather than regulation.”

He sometimes cheats on his own diet. “I’m an admitted chocoholic,” he said. And there’s the occasional occupational hazard: “If it's a cocktail party with people I don't know well, often they'll be self-conscious about what they're eating. And I always feel obligated to have something really bad so they don't feel so bad. That's one of my excuses to cheat,” he laughed.

He has strong views on the state of healthcare in the U.S. “Doctors do extra tests to protect themselves. They’re reimbursed for about five minutes of face time, then they want to get rid of the liability so they send the patient to a sub-specialist. And they sometimes churn and burn because they're trying to pay their own overhead.”

“The amount of regulation now is just overwhelming. Doctors can't stand it. They're going out of business all the time,” he said. “ I had my own practice as a cardiac prevention practice, which I still do today. I spend time with patients. I did the tests I wanted to do. I lost a lot of money every year. Fortunately I had an outside income so I could practice good medicine. I don't know how you can practice good medicine today on the basis of current regulations and current insurance,” he said. Agatston advocates a voucher system for patients who can’t afford to pay, patients spending more time with their primary care physician, and automated consultations with specialists on the Internet.

Still, Agatston said he doesn’t intend to retire anytime soon. “I love to play golf. I love to play tennis,” he said, “but if I'm not working on something new, breaking new ground, I'm just not nearly as happy.”

To unwind, he watches TV. “I watch quite a bit of news. So I sometimes am screaming at the TV, and for me that's relaxation,” he said. “It doesn't get my heart rate up too much.”

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Tuesday, April 23, 2013

Resveratrol: A Potent Anti-Oxidant

A reader sent me the below that she received from a friend.

"Do you know about Resveratrol from Red Grapes and their ability to be a cancer fighting agent? Natural News says that red grapes produce Resveratrol, but they only develop the Resveratrol when they are infected with a fungus, so grapes that are treated with anti-fungus chemicals produce much less resveratrol than their organic counter-parts."

I did not know about the red grape production of resveratrol being dependent upon a fungal infection. The flip side of organic fruits and vegetables, and another reason to go organic, is that they will also have less toxins like the anti-fungal spray. Always beware of the daily load of toxins we are bombarded with, or unknowlingly subject ourselves to.

It is true that Reseveratrol is thought to be a potent cancer fighting agent. More and more Doctors and Nutritionalists are believing that Resveratrol not only protects cells from the damaging effects of cancer treatments such as radiation and chemotherapy, but can enhance effectiveness of these treatments.

I whole heartedly believe in Resveratrol, as well as Grape See Extract, taking 30mg of Resveratrol and 490 mg of Grape Seed Extract from a pharmacuetical grade source every day, as my belief is that the first line of defense against degenerative disease, including cancers, is optimum cellular health.

Quality red wines also contain Resveratrol, although you would have to drink quite a bit to get what you can in a quality supplement.  I guess this can be an excuse to get tipsy each day.   

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Saturday, April 20, 2013

Too Much Salt Can Kill You

I was brought up to know that using too much salt is bad for you but often found myself using quite a bit of it. I think I'm going re-think my habitable after reading this article titled "Salt Can Be Fatal, says Study", by Elise Solé, on the Shine Staff, posted on Healthy Living on Yahoo!

A pinch of salt can perk up your morning omelet—but that innocent shaker is responsible for 2.3 million deaths around the world and 85,000 deaths per year in the United States, says a study released Thursday from Harvard's School of Public Health.

One in ten people die from heart attack, stroke, or other type of cardiovascular disease as a result of eating too much sodium, according to lead study author Dariush Mozaffarian, M.D., Ph.D., Associate Professor in the Department of Epidemiology at Harvard University.

Despite the fact that the World Health Organization recommends limiting sodium to less than 2,000 milligrams a day and the American Heart Association recommends 1,500 mg per day, the global national average for the U.S. is 4,000 mg of sodium," Mozaffarian told Shine. For perspective: One teaspoon of salt has 2,325 mg of sodium.

Researchers analyzed 247 national surveys of sodium intake in 66 countries between 1990 and 2010, then looked at studies that measured how high amounts of sodium affect blood pressure and the risk of cardiovascular disease, including heart disease and stroke. They also obtained the number of deaths from cardiovascular disease from the Global Burden of Disease study.

"Out of all the countries, the United States ranked 19th out of 30 of the largest countries for the most salt consumption relating to cardiovascular death," says Mozaffarian. "When people think of limiting salt, foods like potatoes chips and French fries come to mind but those mainly contain salt on the surface," he says. "Salt isn't just used for taste; it's also used as a preservative in packaged foods like bread and canned foods such as soup which Americans eat a lot of."

Salt is a hard habit to shake, for a few reasons: For starters, along with sweet, sour, bitter, and savory, salt is one of the five basic tastes. Just like some people have a sweet tooth, others crave salt often. Second, a salty tooth may be biologically-determined. Some studies suggest that babies whose mothers suffer from morning sickness have above-average salt appetites because vomiting decreases sodium levels in her body and in the fetus. And other research suggests that stress or anxiety can make us reach for the salt and eventually, just like anything else, adding salt to our meals becomes habitual.

Unsurprisingly, the Salt Institute's vice president of science and research Morton Satin says: "This misleading study did not measure any actual cardiovascular deaths related to salt intake, since, by the authors' own admission, no country anywhere in the world consumes the low levels of salt they recommend...The Salt Institute does not consider this misleading modeling exercise helpful in furthering our knowledge of the role of salt on our health. On the contrary, it is disingenuous and disrespectful of consumers."

If you do want to cut down on your sodium intake, try these tips:

Avoid balsamic vinegar: On salad choose red-wine vinegar instead of its more popular counterpart balsamic, Carly Feigan, a New York City based Clinical Nutritionist told Shine. "Red wine vinegar already contains salt so it will quell your cravings," she says. "Balsamic has a high sugar content and triggers sugar cravings which may have you reaching for more high-sodium packaged foods."

Spice up your meals: The capsaicin in hot sauce will give your eggs or pizza a fiery kick causing skin tingles, flushed skin, and the release of feel-good hormones (called endorphins) and could possibly extinguish the need for extra salt. Feigan's pick: Frank's hot sauces which have the lowest sodium per teaspoon.

Eat a clean diet: Whole foods such as fruits, vegetables, lean meats, and beans contain natural sodium which should satisfy your bodies' natural cravings so you won't reach for the shaker as often.

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Sunday, April 14, 2013

Sugar Laden Ddrinks Kill 25,000 Each Year?

I have a sister-in-law who drinks 12 or more regular Pepsi's a day.  No kidding. This article off the web is for her: 

In a study that's sure to shake up the soda ban debate, Harvard researchers have linked the sugary drinks to 180,000 deaths a year worldwide, 25,000 in the United States alone.

"We know that sugar-sweetened beverages are linked to obesity, and that a large number of deaths are caused by obesity-related diseases. But until now, nobody had really put these pieces together," said Gitanjali Singh, a postdoctoral research fellow at the Harvard School of Public Health in Boston and lead author of the study presented today at the American Heart Association's annual meeting in New Orleans.

Singh and colleagues spent five years putting the pieces together. Using data from national health surveys around the world, the team tied sugar-sweetened beverages to 133,000 deaths from diabetes, 44,000 deaths from cardiovascular diseases and 6,000 deaths from cancer in 2010.

The study adds to mounting evidence that sugar-sweetened beverages, loaded with calories that carry little nutritional value, are a public health hazard.

"I think our findings should really impel policymakers to make effective policies to reduce sugary beverage consumption since it causes a significant number of deaths," said Singh, adding that she thinks "cause" is an appropriate word despite the limitations of the association study.

The American Beverage Association criticized the study, which has yet to be published in a peer-reviewed journal, calling it "more about sensationalism than science."

"It does not show that consuming sugar-sweetened beverages causes chronic diseases such as diabetes, cardiovascular disease or cancer - the real causes of death among the studied subjects," the industry group said in a statement. "The researchers make a huge leap when they take beverage intake calculations from around the globe and allege that those beverages are the cause of deaths which the authors themselves acknowledge are due to chronic disease."

The study comes one week after a judge blocked New York City Mayor Michael Bloomberg's proposed ban on supersized sodas, and one day after Mississippi Gov. Phil Bryant signed a bill preventing municipalities from setting limits on soda and salt content.

"It is simply not the role of government to micro-regulate citizens' dietary decisions," Bryant said in a statement. "The responsibility for one's personal health depends on individual choices about a proper diet and appropriate exercise."

But some experts say evidence-based policies could curb soda consumption and save lives. Dr. Dariush Mozaffarian, senior author of the new study, said he now plans to study the effects of sugary drink regulation and taxation on health and health care costs.

"I think that's the kind of information that policymakers need," said Mozaffarian, who is an epidemiologist at the Harvard School of Public Health.

In the meantime, Americans can take steps on their own to cut sugary drinks and shed pounds.

"It may not be easy at first, but your body will thank you," said ABC News' chief health and medical editor Dr. Richard Besser. "Study after study links intake of sugary drinks to poor health effects."

"It is quite frightening to see the rise in chronic diseases as people around the world consume more and more sugary drinks," Besser added. "It reminds me of the way lung cancer is on the rise around the world as more and more people smoke cigarettes."

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Thursday, April 11, 2013

True Love

This came to me across FaceBook and thought it worthy enough to share,.......

It was approximately 8.30 a.m. on a busy morning when an elderly gentleman in his eighties arrived to have stitches removed from his thumb. He stated that he was in a hurry as he had an appointment at 9.00 a.m.

I took his vital signs and had him take a seat. I knew it would take more than an hour before someone would to able to attend to him. I saw him check his watch anxiously for the time and decided to evaluate his wound since I was not busy with another patient.

On examination, the wound was well healed. Hence, I talked to one of the doctors to get the supplies to remove his sutures and redress his wound.

We began to engage in a conversation while I was taking care of his wound. I asked him if he had another doctor's appointment later as he was in such a hurry. The gentleman told me no and said that he needed to go to the nursing home to have breakfast with his wife.

I inquired about her health. He told me that she had been in the nursing home for a while as she was a victim of Alzheimer's disease. I probed further and asked if she would be upset if he was slightly late. He replied that she no longer knew who he was and she had not been able to recognize him since five years ago.

I asked him in surprise, "And you still go every morning, even though she doesn't know who you are?"

He smiled as he patted my hand and said, "She doesn't know me, but I still know who she is."

I had to hold back my tears as he left. I had goose bumps on my arm, and I thought, "That is the kind of love I want in my life."

True love is neither physical nor romantic. True love is an acceptance of all that is, has been, will be, and will not be.

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Monday, April 8, 2013

Water Replacing Soda Pop?

From an article titled America's new love: Water by Candice Choi of the Associated Press.

NEW YORK (AP) — It wasn't too long ago that America had a love affair with soda. Now, an old flame has the country's heart.

As New York City grapples with the legality of a ban on the sale of large cups of soda and other sugary drinks at some businesses, one thing is clear: soda's run as the nation's beverage of choice has fizzled.

In its place? A favorite for much of history: Plain old H2O.

For more than two decades, soda was the No. 1 drink in the U.S. with per capita consumption peaking in 1998 at 54 gallons a year, according industry tracker Beverage Digest. Americans drank just 42 gallons a year of water at the time.

But over the years, as soda increasingly came under fire for fueling the nation's rising obesity rates, water quietly rose to knock it off the top spot.

Americans now drink an average of 44 gallons of soda a year, a 17 percent drop from the peak in 1998. Over the same time, the average amount of water people drink has increased 38 percent to about 58 gallons a year. Bottled water has led that growth, with consumption nearly doubling to 21 gallons a year.

Stephen Ngo, a civil defense attorney, quit drinking soda a year ago when he started running triathlons, and wanted a healthier way to quench his thirst.

Ngo, 34, has a Brita filter for tap water and also keeps his pantry stocked with cases of bottled water.

"It might just be the placebo effect or marketing, but it tastes crisper," said Ngo, who lives in Miami.

The trend reflects Americans' ever-changing tastes; it wasn't too far back in history that tap water was the top drink.

But in the 1980s, carbonated soft drinks overtook tap as the most popular drink, with Coca-Cola and PepsiCo putting their marketing muscle behind their colas with celebrity endorsements from the likes of pop star Michael Jackson and comedian Bill Cosby.

Americans kept drinking more of the carbonated, sugary drink for about a decade. Then, soda's magic started to fade: Everyone from doctors to health advocates to government officials were blaming soft drinks for making people fat. Consumption started declining after hitting a high in the late 1990s.

At the same time, people started turning to bottled water as an alternative. Its popularity was helped by the emergence of single-serve bottles that were easy to carry around.

Until then, bottled water had mainly been sold in "big jugs and coolers" for people who didn't trust their water supply, said John Sicher, publisher of Beverage Digest.

The new soft drink-like packaging helped fast-track bottled water's growth past milk and beer. In fact, the amount of bottled water Americans drink has risen nearly every year for more than two decades, while the estimates of how much tap water people drink has fluctuated up and down during that time. When taken together, water finally overtook soda in 2008, according to Beverage Digest. (It's difficult to track how much tap water people drink and how much is used for other things like washing dishes, so experts estimate consumption.)

Analysts expect water to hold onto to its top spot for years to come. But whether people will drink from the tap or a bottle is uncertain.

Based on current trajectories, Michael Bellas, the CEO of the industry tracker Beverage Marketing Corp., predicts that bottled water alone could overtake soda within the next decade. That's not counting enhanced and flavored waters, which are growing quickly but remain a small part of the bottled water industry.

Currently, people drink 21 gallons of bottled water a year. That compares with 37 gallons of other water, which includes tap, sparkling, flavored and enhanced waters such as Coca-Cola's vitaminwater.

But there are numerous factors that could tilt the scales in favor of tap water.

Because of concerns that plastic bottles create too much waste, experts say bottled water could be hit by a public backlash similar to the one that has whipsawed the soda industry with pushes for bans and taxes.

New York City was preparing for a ban on cups of sugary drinks that are larger than 16 ounces starting on Tuesday. But on Monday — a day before the ban was to begin — a judge invalidated the regulation. Mayor Michael Bloomberg, who originally proposed the ban, vowed to appeal the judge's ruling.

Bottled water already is starting to face similar opposition. The town of Concord, Mass. earlier this year banned the sale of water bottles that are less than a liter. And the University of Vermont became the first public university to ban the sale of bottled water.

Meanwhile, other cities are waging campaigns to promote tap water. New York City, which touts the high quality of its tap water, offers portable fountains at events around the city.

"Good old marketing has convinced people that they should spend a lot of money on bottled water," says Salome Freud, chief of New York City's distribution water quality operations.

Although companies such as Coca-Cola Co. and PepsiCo Inc. would rather have people buy bottled waters, they're even more invested in getting people to drink more soda again.

That's because soda and other drinks that the companies make, such as sports drinks and juices, are more profitable than bottled water. With bottled water, people tend to buy whatever is cheapest. That's a habit that forces companies to keep prices relatively low, which eats into profits.

It's why companies are investing so heavily in developing nations such as China and India, where the appetite for soda continues to grow.

In the U.S., annual soda sales are more than five times as big as bottled water at $75.7 billion a year, according to Beverage Digest. In terms of volume, soda is only twice as big as bottled water.

At Coca-Cola, the No. 1 soda maker, three-quarters of its volume in gallons comes from soft drinks, compared with 8 percent for its bottled waters including Dasani. PepsiCo, the No. 2 soda maker, gets 64 percent of its volume from soft drinks and only 7 percent from its Aquafina bottled water.

It's why Coca-Cola, which holds 13 percent of the bottled water market compared with PepsiCo's 10 percent, doesn't seem to think bottled water will ever overtake soda. In an emailed statement, the Atlanta-based company noted that soft drinks remain a far larger category than bottled water and that it sees "upside" for sodas over the next several years.

However, the company added that it saw "great potential" for bottled water. Like its competitors, Coca-Cola said it's focusing on growing its portfolio of bottled waters profitably by offering brands such as Smartwater and its flavored vitaminwater, which fetch higher prices.

In the meantime, the chairman and former CEO of Nestle Waters North America, Kim Jeffery, is waiting for bottled water's moment in the spotlight. Nestle, the Swiss company that makes Poland Spring, Nestle Pure Life, Deer Park and other brands, has nearly half of the share of the bottled water market.

At a beverage industry conference late last year, Jeffery noted that bottled water is "the elephant in the room."

And given the growing warnings over drinking too many calories — including from juice, milk and other sugary drinks — Jeffery said he's confident that water will continue to grow in popularity.

"For thousands of years, water was beverage of choice for human beings," he said. "Now we're reverting back to that."

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Wednesday, April 3, 2013

A Couple Concerned About Their Health

I have been talking to a couple, slightly younger than me, but becoming more and more interested in their health as they have several relatives and friends afflicted with cancer, diabetes, menopause, arthritis and other degenerative diseases. I helped them understand the need for a low glycemic diet, a physically active life, taking quality supplements and avoiding toxins where they can.

The couple asked me how I knew so much (in their minds) about health and nutrition and I replied that each individual has to be responsible for their own health - they have to be students of health and life. That their Doctor(s) are advisors, not decision makers for this couple's health.  They asked for a list of reading material, so I sent them some pdf files on health studies and gave them a two lists of books to read. This is the second list, reading for their stated issues and concerns.

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